John Lahart (Dublin South West, Fianna Fail)
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I thank the Ceann Comhairle for allowing me the opportunity to raise a distressing case. It concerns a constituent of mine, the parent of a young boy who was in touch with me. She has a very young family, all aged under seven years. One of her sons, who is aged five, has had ongoing problems with his tonsils since he was approximately two years of age. He has missed a lot of school and when his tonsils are very sore he gets sick constantly, which can go on for between one and three days depending on the severity of the illness.

For a number of years his mother was told a viral infection was to blame, but some weeks ago a family doctor suggested that her son's tonsils needed to be removed. To cut a long story short, she was advised that paying a private ear, nose and throat specialist in a private hospital would speed things up. A tonsil checkup for two of her children cost €350.

I have been informed that the specialist suggested that the tonsils need to be removed and that it would cost approximately €3,000 to have the procedure undertaken privately; otherwise, her son would go on a waiting list. The family does not have €3,000. The waiting list in Tallaght hospital is at least one year. The principal of the local school wrote to me and the local hospital to outline the fact that the child has missed a lot of school due to sickness related to tonsillitis. The child is falling behind in school and she is extremely concerned about him. She has other children aged under 7 to care for.

I have been in touch with Tallaght Hospital and have received correspondence from its chief executive about the patient. The CEO acknowledged the facts around the case in terms of the waiting time. He said a referral letter for the patient was received and reviewed on 13 April and that the referral was triaged as routine. The current waiting time for a routine referral in the hospital is 17 months. The hospital has recognised that this is an unacceptable length of time for anyone to wait for an appointment. On top of this, the hospital is the only paediatric hospital on the south side of Dublin that is accepting routine ear, nose and throat referrals. Demand for paediatric ear, nose and throat services has increased by 51% over the past two years. Things will only get worse, not just for this child but for many others.

The CEO confirmed that he has raised this issue with the HSE and, in fairness, a new paediatric ear, nose and throat consultant was approved, but the successful candidate withdrew from the recruitment process and the job is being re-advertised. In addition to there being no locum available for this position, the paediatric sessions from a recent consultant retirement also remain unfilled. The CEO stated that the children's hospital group has approached the HSE to seek support for an ear, nose and throat waiting list initiative with the private sector and is awaiting a response.

In conclusion, the CEO said the hospital cannot at this time offer the patient an appointment date, and the hospital apologised for that.

I have a few questions for the Minister. Under the supply and confidence arrangement between Fianna Fáil and Fine Gael, it was agreed that the National Treatment Purchase Fund, NTPF, would be reinstated. Does the issue I raised come under the remit of the NTPF? The CEO has approached the HSE to seek support for a waiting list initiative in that regard. Tallaght hospital is part of the Dublin Midlands hospital group. Is there any alternative hospital at which the parent in question can seek to get treatment for her son? It is a shame the Minister cannot be here, but I accept that he is unable to be present. What is his response to the issue and what advice can I, as the local Deputy, give to the distressed parent whose child may have to wait another 17 months, which I am sure the Minister of State will agree is completely unacceptable?

Marcella Corcoran Kennedy (Offaly, Fine Gael)
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I thank Deputy Lahart for raising this important issue today and for giving me the opportunity to update the House on it. Tallaght hospital provides a full range of ear, nose and throat, ENT, services, including tonsillectomy services, for both adults and paediatrics, with the exception of paediatric ENT airway management. Within the ENT services, tonsillectomy waiting times are not separately identified but are reported on as part of the ENT service overall. As published by the NTPF, the most recent waiting times for ENT services at Tallaght show 278 children and 321 adults awaiting inpatient or day case treatments. Of those, 87 adults and 64 children have been waiting longer than a year.

It is clear that the services are experiencing capacity challenges, which is of great concern to us all. In order to address the challenges, I am advised that the hospital has been working with the HSE in relation to the recruitment of ENT consultants. I am pleased to say that two consultant posts are currently in recruitment to fill vacant posts. One of those is a replacement post, providing both adult and paediatric services, while the second is a new post to provide adult ENT services. A further new paediatric consultant post has been re-advertised following a previously unsuccessful recruitment campaign. The posts, when in place, will improve access to ENT services at Tallaght. The hospital is also implementing other initiatives to optimise the capacity of the existing services, including nurse tonsillectomy triage and nurse-led grommets review clinics in paediatrics.

In the health system as a whole there has been a considerable and increasing demand for care. We are now seeing in a year approximately 3.2 million outpatient attendances at hospitals, while 100,000 patients have an elective inpatient procedure and more than 800,000 have a planned day case procedure. Clearly, that has increased pressure on waiting times, as the Deputy will be aware, which means that a sustained commitment to improving waiting times for patients across the health service is urgently needed. That is why the programme for a partnership Government commits to continued investment of €50 million per year specifically for the purpose.

A scheduled care governance group has been established in the HSE to co-ordinate key initiatives to reduce waiting times and the number of patients awaiting treatment. Actions overseen by the group include driving greater adherence to chronological scheduling, relocation of low-complexity surgical procedures to smaller hospitals and administrative and clinical validation procedures to ensure that patients are available for treatment. In addition, each hospital group has been mandated to designate a key person to lead and support waiting list management improvements in order to advance towards compliance with maximum waiting times.

I wish to reassure the House that officials in the Department of Health are working with the NTPF and the HSE to urgently address waiting lists across the health service for those waiting longest. The initiatives will be funded by the annual commitment of €50 million, to which I have already referred. The amount includes ring-fenced funding of €15 million in 2017 for the National Treatment Purchase Fund. That will allow us to balance demand and capacity in acute hospital services, including Tallaght hospital, and utilise primary, social and community care services to support the health of citizens.

John Lahart (Dublin South West, Fianna Fail)
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The news is reasonable if one were to take a helicopter view of the situation, but the stark fact is in the first paragraph of the Minister of State's reply - that is, that a total of 64 children have been waiting longer than a year for ENT services. I appreciate that the Minister of State has attempted to respond to some of the issues I raised, including whether there is another hospital within the hospital group in which services can be provided. I accept that efforts are being made by the Minister to relocate some procedures to those hospitals. Could the Minister respond directly to the case I raise? There is no good news specifically for my constituent. I wonder what I will go back and tell the parents of the child in question. I could say X and Y is happening from a macro perspective but there is no good news in terms of the specific child's needs being met immediately. I acknowledge the efforts made by the Minister of State to respond but I request that she speak personally to the Minister for Health. I accept that he would not have been apprised of the specific nature of individual case when he received notice of the Topical Issue but I would be very grateful if he could examine the matter and respond specifically to the case I raise.

Marcella Corcoran Kennedy (Offaly, Fine Gael)
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I thank Deputy Lahart again for reiterating his concerns for his constituent. I am very familiar with the type of query raised because there are also challenges in the midlands region in terms of recruitment of the required professionals to help clear the waiting lists. I will refer the Deputy's query to the Minister if he wishes to give me the specific details and I will endeavour to be of whatever assistance I can to him.